Surgical clip appliers have been utilized to overcome some of the difficulties associated with suturing. However, a large subset of clip appliers known in the art are single-use devices, capable of deploying only a single clip or set of clips at one time. To deploy another clip or set of clips, a new device must be utilized, or the device must be reloaded with another cartridge of clips. Where multiple clips must be placed at different locations in the body, such use of multiple tools is time consuming, expensive and wasteful. Some surgical clip appliers known in the art are capable of deploying multiple clips, one after the other, in different locations in the body. However, such tools are complex and bulky, and may be incapable of deploying clips properly sized to be useful in some minimally invasive surgical procedures.
Coagulation-based devices for dissecting tissue also are known and used in surgical procedures. These devices clamp tissue, deliver energy such as RF energy or ultrasound to tissue in order to cause coagulation to heat seal the tissue, then use a knife to cut the tissue. A surgeon may use such a device, for example, to separate side branches from a saphenous vein during endoscopic vein harvesting in preparation for coronary artery bypass graft (CABG) surgery. However, in the course of using a coagulation-based device, the surgeon may encounter blood vessels that are larger than a coagulation-based device can safely handle. Consequently, the surgeon must then set aside the coagulation device and switch to a separate clip applier. Switching between tools is time-consuming, expensive, and inconvenient, particularly in minimally-invasive, laparoscopic, or port-access surgical procedures, where the tissue to be dissected can be lost upon withdrawal of the tool such that the surgeon must spend time finding that tissue again upon the insertion of a different tool.
The use of the same reference symbols in different figures indicates similar or identical items.